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Anaerobic ammonium oxidation (anammox) is one of the most promising processes for the treatment of ammonium-rich wastewater. It is more effective, cheaper, and more environmentally friendly than the conventional process currently in use for nitrogen removal. Unfortunately, anammox bacteria are sensitive to various substances, including heavy metals and organic matter commonly found in the wastewater treatment plants (WWTPs). Of these deleterious substances, antibiotics are recognized to be important. For decades, the increasing consumption of antibiotics has led to the increased occurrence of antibiotics in the aquatic environment, including wastewater. One of the most important issues related to antibiotic pollution is the generation and transfer of antibiotic resistance bacteria (ARB) and antibiotic resistance genes (ARGs). Here, we will discuss the effect of short- and long-term exposure of the anammox process to antibiotic pollutants; with a special focus on the activity of the anammox bacteria, biomass properties, community structures, the presence of antibiotic resistance genes and combined effect of antibiotics with other substances commonly found in wastewater. Further, the defense mechanisms according to which bacteria adapt against antibiotic stress are speculated upon. This review aims to facilitate a better understanding of the influence of antibiotics and other co-pollutants on the anammox process and to highlight future avenues of research to target gaps in the knowledge. [ABSTRACT FROM AUTHOR]